Symptomatic Improvement in Irritable Bowel Syndrome With Oral Ketamine.

Introduction: Irritable bowel syndrome (IBS) often is treated as a partially diet-responsive functional bowel disorder. Few interventions have been found to be effective in diet-refractory IBS, leading to lifestyle disruptions due to persistent symptoms. The efficacy of low-dose home ketamine therapy suggests others may benefit.

Case presentation: A female patient in her 60s with progressive presumed IBS with diarrhea found diet-based treatments ineffective, resulting in severe lifestyle disruptions. After a hysterectomy, intolerance to opioids for postoperative pain prompted the use of intravenous ketamine. An unexpected and prolonged improvement in IBS symptoms resulted. The patient sought continued treatment with ketamine for IBS symptoms and experienced continued symptomatic relief with 20 mg oral ketamine every 2 weeks at home.

Discussion: No other published cases of ketamine for IBS were found.

Conclusions: While dietary changes remain the gold standard for IBS, this patient experience highlights ketamine as a potential adjunct therapy.